SHANNON BLAKE

WEST HARTFORD, CT
NPI1578509238
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CT  001550)
Enumeration Date2006-06-21
Last Update Date2011-07-28
Business Address
-- SHANNON BLAKE PA
631 QUAKER LN S
WEST HARTFORD, CT 06110-1026
Phone number: 860-233-5133
Mailing Address
-- SHANNON BLAKE PA
229 HENRY ST
MANCHESTER, CT 06042-3243
Phone number: 860-371-5335
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